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http://dx.doi.org/10.3340/jkns.2015.57.4.266

Independent Predictors for Recurrence of Chronic Subdural Hematoma  

Jung, Yoon-Gyo (Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine)
Jung, Na-Young (Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine)
Kim, El (Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.57, no.4, 2015 , pp. 266-270 More about this Journal
Abstract
Objective : Chronic subdural hematoma (CSDH) is one of the most frequent problems encountered in neurosurgery. Although burr-hole trephination is widely performed to treat CSDH, the incidence rate of recurrent CSDH is still 2-37%. The goal of this study is to determine the risk factors that affect recurrent CSDH. Methods : A total of 182 patients were included in this study who underwent burr-hole trephination. The clinical factors and radiographic features between the recurrence and the no recurrence groups were analyzed to find the parameters related to the postoperative recurrence of CSDH. Results : For the recurrence of CSDH that occurred in 25 patients (13.7%), among various risk factors, pre and postoperative midline displacements, which are more than 10 mm (p=0.000), and preoperative hemiparesis (p=0.026) had contributed to recurrent CSDH with statistical significance by univariate analysis. Unilateral CSDH were more frequently related to recurrent CSDH (16.3%), although it was not a statistical significant result (p=0.052). Furthermore, preoperative midline displacement only had statistical meaning for the recurrence of CSDH by multivariate analysis. Conclusion : This study indicates that the midline displacement on the preoperative computed tomography scan is the only independent predictor for the recurrence of CSDH.
Keywords
Chronic subdural hematoma; Hemiparesis; Midline displacement; Recurrence;
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1 Torihashi K, Sadamasa N, Yoshida K, Narumi O, Chin M, Yamagata S : Independent predictors for recurrence of chronic subdural hematoma : a review of 343 consecutive surgical cases. Neurosurgery 63 : 1125-1129; discussion 1129, 2008   DOI
2 Yamamoto H, Hirashima Y, Hamada H, Hayashi N, Origasa H, Endo S : Independent predictors of recurrence of chronic subdural hematoma : results of multivariate analysis performed using a logistic regression model. J Neurosurg 98 : 1217-1221, 2003   DOI
3 Youmans JR, Winn HR : Youmans Neurological Surgery, ed 6. New York : W.B. Saunders, 2011, pp532-543
4 Abouzari M, Rashidi A, Rezaii J, Esfandiari K, Asadollahi M, Aleali H, et al. : The role of postoperative patient posture in the recurrence of traumatic chronic subdural hematoma after burr-hole surgery. Neurosurgery 61 : 794-797; discussion 797, 2007   DOI
5 Chon KH, Lee JM, Koh EJ, Choi HY : Independent predictors for recurrence of chronic subdural hematoma. Acta Neurochir (Wien) 154 : 1541-1548, 2012   DOI
6 El-Kadi H, Miele VJ, Kaufman HH : Prognosis of chronic subdural hematomas. Neurosurg Clin N Am 11 : 553-567, 2000
7 Ernestus RI, Beldzinski P, Lanfermann H, Klug N : Chronic subdural hematoma : surgical treatment and outcome in 104 patients. Surg Neurol 48 : 220-225, 1997   DOI
8 Fukuhara T, Gotoh M, Asari S, Ohmoto T, Akioka T : The relationship between brain surface elastance and brain reexpansion after evacuation of chronic subdural hematoma. Surg Neurol 45 : 570-574, 1996   DOI
9 Hamilton MG, Frizzell JB, Tranmer BI : Chronic subdural hematoma : the role for craniotomy reevaluated. Neurosurgery 33 : 67-72, 1993   DOI
10 Ikeda K, Ito H, Yamashita J : Relation of regional cerebral blood flow to hemiparesis in chronic subdural hematoma. Surg Neurol 33 : 87-95, 1990   DOI
11 Inao S, Kawai T, Kabeya R, Sugimoto T, Yamamoto M, Hata N, et al. : Relation between brain displacement and local cerebral blood flow in patients with chronic subdural haematoma. J Neurol Neurosurg Psy chiatry 71 : 741-746, 2001   DOI
12 Kotwica Z, Brzeziński J : Chronic subdural haematoma treated by burr holes and closed system drainage : personal experience in 131 patients. Br J Neurosurg 5 : 461-465, 1991   DOI
13 Nakaguchi H, Tanishima T, Yoshimasu N : Relationship between drainage catheter location and postoperative recurrence of chronic subdural hematoma after burr-hole irrigation and closed-system drainage. J Neurosurg 93 : 791-795, 2000   DOI
14 Kwon TH, Park YK, Lim DJ, Cho TH, Chung YG, Chung HS, et al. : Chronic subdural hematoma : evaluation of the clinical significance of postoperative drainage volume. J Neurosurg 93 : 796-799, 2000   DOI
15 Markwalder TM : Chronic subdural hematomas : a review. J Neurosurg 54 : 637-645, 1981   DOI
16 Nakaguchi H, Tanishima T, Yoshimasu N : Factors in the natural history of chronic subdural hematomas that influence their postoperative recurrence. J Neurosurg 95 : 256-262, 2001   DOI
17 Ohba S, Kinoshita Y, Nakagawa T, Murakami H : The risk factors for recurrence of chronic subdural hematoma. Neurosurg Rev 36 : 145-149; discussion 149-150, 2013   DOI
18 Oishi M, Toyama M, Tamatani S, Kitazawa T, Saito M : Clinical factors of recurrent chronic subdural hematoma. Neurol Med Chir (Tokyo) 41 : 382-386, 2001   DOI
19 Okada Y, Akai T, Okamoto K, Iida T, Takata H, Iizuka H : A comparative study of the treatment of chronic subdural hematoma--burr hole drainage versus burr hole irrigation. Surg Neurol 57 : 405-409; discussion 410, 2002   DOI
20 Stanisic M, Lund-Johansen M, Mahesparan R : Treatment of chronic subdural hematoma by burr-hole craniostomy in adults : influence of some factors on postoperative recurrence. Acta Neurochir (Wien) 147 : 1249-1256; discussion 1256-1257, 2005   DOI
21 Tanaka A, Yoshinaga S, Kimura M : Xenon-enhanced computed tomographic measurement of cerebral blood flow in patients with chronic subdural hematomas. Neurosurgery 27 : 554-561, 1990   DOI
22 Foelholm R, Waltimo O : Epidemiology of chronic subdural haematoma. Acta Neurochir (Wien) 32 : 247-250, 1975   DOI
23 Ko BS, Lee JK, Seo BR, Moon SJ, Kim JH, Kim SH : Clinical analysis of risk factors related to recurrent chronic subdural hematoma. J Korean Neurosurg Soc 43 : 11-15, 2008   DOI
24 Wakai S, Hashimoto K, Watanabe N, Inoh S, Ochiai C, Nagai M : Efficacy of closed-system drainage in treating chronic subdural hematoma : a prospective comparative study. Neurosurgery 26 : 771-773, 1990   DOI